Claims process

What is Claim scrubbing?

Automated pre-submission checks that catch coding and data errors before a payer sees the claim.

Also known as
claim edits · pre-submission edits · claim scrubber

Definition

A scrubber runs a claim against edit rules — NCCI bundling pairs, modifier validity, medically unlikely edits, payer companion-guide requirements, required-field completeness — and flags failures for correction before submission.

The value is in the arithmetic: a defect caught pre-submission costs a moment of a biller’s attention, while the same defect caught by the payer costs a denial, a rework cycle, and 30 or more days of AR. Scrubbing is the cheapest possible point of intervention.

Why it matters

Clean claim rate is what a scrubber moves, and clean claim rate drives both days in AR and cost to collect.

Denial codes to know

Related terms

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